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1un-01-2001 09:14am Fram-CITY OF ORONG +9522494616 T-i52 P.003/003 F-23o •� <br /> . . �i � <br /> Sr..l7.0i FtJGHTS OF SUBJECTS aF A,�Ta <br /> Subd. l. Type of da[a. Thc rig4u of individa�l oo whom c�e da�a is sc�rrJ or co be scorcd shaU bc as scc fo�sh iu this sccpoa. <br /> Sub4.3. Irlormation teq�red to be p�w iudividwl. An icQcviCu�l ui.�te supPlY Pnvam ot eonfideaoal da�a eoneeraing himsdf shzl! <br /> be inforu�ed of: (a} chc purpose and iaundeC use o!�e rcquesud d�a y^:�siu�c collecang Y�te aYeacY.Dotidcsl sabdirisioa,or stsscw-�dc syss:.�; <br /> ;b)whether he may rsfuu or is Ieqally rcquicsd to supply�e mqt,esaed dia:(c}xny i�ewa coascqueaee arisiag trom d;s auPP�Y�B or reFusing w scPN�Y <br /> privace ot conndcndal da�a;astd(d)ehe iZersdry af o�hcr persons or caddes s�chorizeQ by s�ce or federal law to rccciYe che d�u.,This ceql:ir_roe�c sbail <br /> nc��pply wktn ar.ir.Qi�'idual is�sktd[o Supply il�vesdgtdvt dan,purfuuc w sueo� 13.$�, subdivisian S,w a laW entorcement vfticer. <br /> The commissioner of re��enue mav F1scc [he f19RCe (eqtifK�Lrd•f tT1t5 T�b'����SiO� U7 �11e It�Qivjduil incAne f�x Or Dropertv 61z refund <br /> '�nscruccions inscead of on_chose fonns. <br /> SaW.3. Access io d�ta Dy iadfvidual. Upon iequesi�o�resFoasiblc zu�oriry,;�u inEividux!shaU be inlo[med wheeher he is the subjc;.t <br /> o(s�oced da�s or�individaals,and wt;e�er it is elassified as pubtic,pciv�c�or cantld�nra Upan hi5 funDer requcs:,au icdividual who is che sub;:c� <br /> of smrel pri�ace or pubiic dxta on indiviQuals s'.tal1 be s5cvm che dua wiz:v�u any c..ar�e to hun a.�d:if hc desues, SbaL' be in°ecmeQ of che cvnce:u <br /> ard meani�g of dtat dara. After an iadi�idua!hu bccn shown e.`�c priva�d�c�and ir.'�cmed o:is meaniag,thc dara aeed not be d'uelosed ro Lim for <br /> six a�on•Ju c:lerwicer unleu a dispute a�acdon pars�anc tu �his sccuan ii ccndmg or addicc�]dsu on the individuai has beea coUccud o�c:eaccQ. <br /> 'ire responsibk authortry shall pr�viQe coaies of:Jie privau or public dsca c�on tequu:b.4h:individuai subjeee ol che data. 'It�e respoasiCiC i�:SOr.fy <br /> may requir�ehe requestiog penon�o p�y ihc scaat cosu oC�r�cirg,eer��ag,�^.0 compiling the eopies. <br /> '!'he«sponsible�athoriry shslt comply immed'w�ciy,if possibi:,wich aay r-quesc eiade pncsuartic to�his subdivision,or wichir►five days af <br /> che daea of�F.e reques�,excluCing SsA=rd�ys,Sundaya and legal hetidxys,if i.r.medi¢cs cempliuxc is not potsiblc. Yf hc catwot campiy widt�;r request <br /> w:thin Lhu rise,ha sltall so intacm the indi��idunl,and may Fave an addi=oaai fcre day's N:�hiri whieh eo cornply wE�h cAc cequesc,exciuding 5aeu:days, <br /> Surdays a;�d lcgsl kolidslys. <br /> Subd.4. Yr�cedur�whea data is aot accur�to or ccmpkte. An indivieu�i a�ey conust she aeeuraey or co►apte�rness oF pe�biic er pri�•ac: <br /> d��eonceming hin:self. To cxer:ise chis righc.sn indivAna!sh�!neaP��wr,[irg�:c rzsponsibic au;hority dtscribing�te r.acute of thc disa�ne�eac. <br /> 'rhe responSib!t authori.y sha1l wichin 30 dgys eit�er: (a)eorteci che d�r�foursd co L'e inac:uratc vr incompless snd uiempt to nodPy pas�iecipi�nu ef <br /> in�ccu�a�e o�ineomplece dxa,uu.tud'us; reciyirnu na:icd by�hc i�div:dcy:or Cb) �o�ty the indiviCual cha�he bdieves d�e daa to be eorrece. Daa <br /> in diipu:e shall be discivsed oalq if the iad,�idual's S�acsrpa,c of d�s:grr.�ent is sc'.��C.d wich the disclosed da�a. <br /> 'Ihe dtamtinadoa of c.tie rospoosibTe au�harip+may bc apptytd purruuc to ti`�e p:ovisio�s of the ad�siniscranve procedu�e aec:eSadnc w <br /> con�esced casrs. <br /> DATA. PRIVACY AD�'ISOR'Y <br /> In accorducce �vith M.S. 13.04, Subd.2, "Ri�hts of subjec[s oi data", we would like to infGrcm you that your request <br /> for a pecauc or lieease frem the City af Orono or any of iu dcpar:�.eats :nay require you to fumis�ceRain privace ar <br /> co:�fdcntial informacioa. <br /> Ycu are nocified ehat: <br /> 1, The inform�tion you fumish wilt be used.o de;rcmina;ou:qualification for chc permit or lieense raquested. <br /> 2. You mny refuse te supply data, huc refusal may tequire that the Ciry deny t�e petmic or Iicease- <br /> 3, The information may be shared with ocha loczl, state or federal aaaneies �o�he exun:neeessary ca process <br /> thc permi� or licease. <br /> 4. If yosr requested permit or license sequires Couacil action co approve, some iuforuia�ioa ma;+ become <br /> . , public. • • <br /> j, You have eenain righcs under M.S. 13.04 (availatl: upva request) �o rtview privace daca an yoursetf. <br /> 6, Your fuIl namc is rcr�uired to pro�ess this zgplica�ioa or permit. <br /> Fi�st Middie L�st <br /> �r�mier t�ome En�ancer� <br /> ,�ddreu 9707 Tenth Avenue No <br /> Ciry Sa[e Zip Phone . <br /> I undccs�ar�a my ri,hrs � stated �bove. <br /> , <br /> �,�,C�Z:` 2c�-E��'� <br /> Si3nsturc ;, <br />